Predicting Pulmonary Graft Loss Using Oxygen-enhanced MRI T1 Mapping in a Prospective Study

Area of Science:

• Radiology
• Pulmonary Medicine
• Transplant Surgery

Background:

• Chronic lung allograft dysfunction (CLAD) is a leading cause of graft loss after lung transplantation.
• Early detection of graft dysfunction is crucial for patient survival and management.
• Oxygen-enhanced MRI T1 mapping offers a non-invasive method to assess lung function and perfusion.

Purpose of the Study:

• To evaluate the predictive accuracy of oxygen-enhanced MRI T1 mapping parameters for detecting CLAD-related graft loss.
• To assess these parameters at 6-12 months post-transplant and over a 2.5-year follow-up period.
• To compare the predictive efficacy of MRI parameters with spirometry for graft loss.

Main Methods:

• A prospective, longitudinal study of 141 lung transplant recipients.
• Acquisition of oxygen-enhanced MRI T1 mapping parameters (OTF, delta T1 OV) at 6-12 months post-transplant and at 2.5-year follow-up.
• Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess graft loss prediction.

Main Results:

• Oxygen-enhanced MRI parameters, including delta T1 median and delta T1 oxygenated volume (OV), predicted graft loss within 5.6 years post-transplant.
• At follow-up, changes in OTF, delta T1 OV, and FEV1 predicted poorer survival.
• Delta T1 OV demonstrated consistent predictive capability for future graft loss.

Conclusions:

• Oxygen-enhanced MRI T1 mapping parameters are effective predictors of CLAD-related graft loss.
• Delta T1 OV is a particularly reliable biomarker for predicting future graft loss in lung transplant recipients.
• These findings support the use of oxygen-enhanced MRI in monitoring lung allograft health.